胎儿和新生儿肺炎症反应与绒毛羊膜炎的关系  

Pulmonary inflammation of fetus and neonates in the presence of chorioamnionitis

作　　者：曹蕾[1] B.Schmidt C.P.Speer 

机构地区：[1]河北省人民医院儿科,石家庄050051 [2]Wuerzburg大学儿童医院

出　　处：《中国优生优育（1990-2002上半年）》2001年第2期69-72,共4页Journal of Improving Birth Outcome and Child Development of China

摘　　要：目的 探讨绒毛羊膜炎对胎儿和新生儿肺炎症反应的影响。方法 组织学检查胎盘有无绒毛羊膜炎;应用原位基因杂交技术,免疫组织化学法和常规组织染色技术研究肺炎症反应。结果 在27例胎儿中发现7例胎盘有绒毛羊膜炎改变;9例早产新生儿中有6例胎盘有绒毛羊膜炎改变;CD 68阳性巨噬细胞、白细胞弹性蛋白酶(N-elastase)阳性多核粒细胞、chloracetatesterase阳性细胞和IL-8mRNA基因表达在绒毛羊膜炎组胎儿和新生儿肺组织中明显高于无羊膜炎感染组,差异有显著性(P<0.05)。结论 胎盘感染引起胎儿和新生儿肺组织细胞因子表达增加,提示肺炎症反应的发生始于产前。绒毛羊膜炎是引起胎儿和新生儿肺炎症反应的重要因素,也是发生RDS和CLD的危险因素之一。Objective Suspected subclinical intrauterine inflammation related to elevated proinflammatory cytokines in amniotic fluid constitutes a risk factor for postnatal development of chronic lung disease. Cellular immune response, mRNA-cytokine expression in fetal and neonatal pulmonary tissue in the presence or absence of chorioarnnionitis were investigated. Methods Serial tissue sections were obtained from 27 fetuses and 9 newborns. Immunhistochemical staining comprised lineage-specific markers (CD68, neutrophil elastase, CD3+). In-situ-hybridisation to assess the expression of interleukin-8 mRNA in the fetal and neonatal lung were undertaken. Results 7 out of 27 fetuses and 6 out of 9 newborns had been exposed to chrioamnionitis . Fetal and neonatal lung showed more increase in density of CD68 positive macrophages and neutrophils in the presence of chorioarnnionitis than that in the absence of chorioarnnionitis. Exposure to chorioarnnionitis resulted in Interleukin-8 (IL-8) mRNA expression higher compared to cell counts of the non-infectious group. Conclusion Chorioarnnionitis play an importent role in the pathophysiological mechanisms of fetal and neonatal pulmonary inflammation. This data strongly supports an association between chorioarnnionitis and inflammatory bronchopulmonary response in the development of neonatal respiratory distress syndrome (RDS) and chronic lung disease of prematurity (CLD).

关 键 词：胎儿 婴儿 新生儿 肺炎症反应 白细胞介素-8 原位基因杂交技术 

分 类 号：R722.1[医药卫生—儿科]